RESUMO

INTRODUCTION: French Guiana is a French territory bordering Brazil and Suriname where the COVID-19 pandemic has severely strained the French Guianese health system. The people working on illegal gold mining sites in French Guiana, also known as garimpeiros, are mainly of Brazilian origin. Their health conditions are precarious, they live under the radar of the surveillance system and therefore, assessment of their health is quite challenging.. The objective of this study was to describe their knowledge, attitudes and practices regarding COVID-19 and vaccination against this infection. METHODS: We conducted an international multicenter cross-sectional survey between 1 March 2022 and 30 April 2022 in French Guiana and Suriname, using a structured questionnaire. RESULTS: Eighty persons were included, 95.0% of whom were Brazilian. Most had good general knowledge of COVID-19. Antibiotic prophylaxis had been practiced by 10.0% of participants. Forty-three people thought they had been infected with COVID-19 (53.8%). Self-medication was frequent, often with antibiotics (32.6%, mostlychloroquine, ivermectin or azithromycin) and most had not consulted a physician for symptoms of COVID-19. A majority (62.5%) had received at least one dose of vaccine. Those who were ever tested for COVID-19 were the most likely to be vaccinated (PR = 1.98, p = 0.009). CONCLUSIONS: Garimpeiros have a good level of knowledge about COVID-19 but the high consumption of antibiotics raises concerns about the selection of resistant bacteria. The vaccination rate was higher than that of the Guianese population. The most vaccinated individuals were those who had already taken a COVID test suggesting that these individuals had more exposure to the disease, were more health conscious, or had easier access to health centers.

RESUMO

OBJECTIVES: We examine the prevalence and sociodemographic risk factors of skeletal indicators of stress in forensic samples of undocumented migrants from Mexico and Central America. MATERIALS AND METHODS: Cranial and dental remains of 319 migrants recovered in the Arizona and Texas borderlands were assessed for porotic hyperostosis (PH), cribra orbitalia (CO), and linear enamel hypoplasias (LEH). Logistic regression models for each condition were estimated to test for associations with biological sex, age, recovery location, and whether individuals were identified. Additional models estimated for a subsample of identified migrants included region of origin, residential context, and community indigeneity. RESULTS: The full sample shows moderate crude prevalence of CO (9.6%) and LEH (34.1%), and a high prevalence of PH (49.6%). Significantly higher odds of PH are associated with being male (2.16 times higher), unidentified (1.89 times higher), and recovered in Arizona (3.76 times higher). Among identified migrants, we fail to find associations significant at the p < 0.05 level between skeletal stress and all sociodemographic variables except age. DISCUSSION: The factors associated with PH may be related to influences on decisions to migrate and diversity among migrant sending regions. The skeletal evidence for early life stress is generally consistent with common public health concerns among impoverished communities in the region. The lesions themselves are viewed as embodied risk of physiological disturbance when resource access is structured by higher-level social, economic, and political forces. Forensic anthropologists would benefit from increased sensitivity to embodied structural violence among the vulnerable individuals and communities they serve.

Assuntos

RESUMO

This study identified risk factors for health and access to healthcare services of migrants during their journey across Mexico to the United States. Data were collected in shelters located in Monterrey, the largest city of northeastern Mexico, through a basic clinical examination and a survey completed by 75 migrants; 92% of them were undocumented Central Americans. During their transit, they are at a high risk of contracting, developing, and transmitting diseases. The need of working to survive affects health-seeking behavior and a constant fear of being traced keeps migrants away from public health services, which delays diagnosis and treatment of diseases. Negligent lifestyles, such as smoking, drinking (31.8% of men and 11.1% of women), and drug abuse (13% of men and 11% of women), were found. Regarding tuberculosis (TB), undocumented migrants are usually not screened, even though they come from countries with a high TB burden. Besides, they might be overexposed to TB because of their living conditions in overcrowded places with deficient hygiene, protection, and malnutrition (54.7% of the sample). Possible comorbidities like acquired immune deficiency syndrome (AIDS; 4%) and diabetes (2.7%, but probably under-diagnosed) were referred. Migrants have little TB knowledge, which is independent of their level of education or a previous experience of deportation. About one-third of the migrants were totally unfamiliar with TB-related symptoms, while 36% had correct knowledge of basic TB symptoms. We conclude that a shortage of information on the highly vulnerable migratory population combined with a lack of social support and health education among migrants may play a significant role in the spread of communicable diseases. We recommend that health authorities address this urgent, binational, public health concern in order to prevent outbreaks of emerging infections.